THE NEUROLEPTIC malignant syndrome (NMS) is characterized by severe extrapyramidal dysfunction, hyperthermia, and autonomic disturbances following neuroleptic usage.1,2 This relatively uncommon, potentially lethal syndrome carries a mortality of 20%, yet it is largely unrecognized by physicians and most workers engaged in the neurosciences. Anticholinergic or benzodiazepine treatment, commonly used for neuroleptic neurological side effects, is usually of limited success in the treatment of NMS; a long hospital course with considerable physical disability often is a result in those patients who survive.3 We present two patients with NMS: the first treated in the usual fashion in our medical intensive care unit (ICU), the second on our psychiatric ward, with the rapidly successful and first reported usage of bromocriptine mesylate.
Report of Cases
Case 1.—
A 28-year-old married woman had been well until Feb 2, 1977, when an acute schizophrenic psychosis with paranoia and catatonia rapidly developed. During her first